Medical home treatment system

Abstract

Some examples of the disclosure are directed to the processing of medical claims data, electronic health records (EHR) data and other data to define disease/treatment pools and risk bands to assist in the treatment of diseases such as cancer. In some examples, in accordance with these defined disease/treatment pools and risk bands, participating practices (e.g., health care providers, clinics, cancer centers, etc.) can provide outpatient care in accordance with determined triage pathways that ensure patients receive the right care in the right place at the right time for symptoms related to their disease(s) and treatment, and determined clinical pathways that address, as applicable, appropriate imaging, pathologic testing and molecular diagnostics, delineating chemotherapy, radiation oncology, supportive care, and surgery. A centralized system may monitor electronic health records maintained by the participating practices to determine whether the participating practices are in compliance with determined clinical pathways.

Description

FIELD OF THE DISCLOSURE[0001]This relates generally to the treatment of diseases, and in some examples to the processing of patient claims data, electronic health records and other data to determine disease / treatment pools, risk bands, and compliance with clinical pathways to assist in the treatment of diseases such as cancer.BACKGROUND OF THE DISCLOSURE[0002]Cancer patients are often acutely ill, and may require complex and expensive treatments and suffer treatment side effects that need to be effectively managed. One model of care delivery is the concept of a patient-centered medical home (PCMH). Some of the goals of PCMHs are to achieve improved quality and higher patient satisfaction. Most medical home treatment models are based on the Chronic Care Model (CCM), for which there is plentiful research documenting the positive effects of the CCM on chronic disease outcomes. Recent studies have shown that medical homes can significantly reduce costly emergency department (ED) visits ...

AI Technical Summary

Benefits of technology

[0004]The medical home treatment system according to some examples of the disclosure can compute and implement these data-based and analytically-derived clinical pathways to keep patients in the physician's office for care and out of the hospital and ED as much as possible. The medical home treatment system may include central computing systems that monitor electronic health records maintained by physicians at remote computing equipment to determine whether patient care complies with the clinical

Problems solved by technology

Because treatment for diseases such as cancer can be highly complex and expensive, ensuring high quali

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